四肢血管损伤治疗的临床分析

Analysis of Vascular Injuries of the Extremities

目的:观察影响四肢血管损伤预后的主要因素.方法:报告近10年来治疗的78例血管损伤伴随肢体损伤.其中车祸29例,工伤19例,累及(?)动脉为首20例.结果:31例重建损伤血管在6h之内,骨折采用髓内针方式固定26例,53例肢体存活具有良好的功能,一期截肢 10例,二期截肢 1例。结论:挽救肢体的预后主要取决于肢体缺血时间,神经损伤的程度,骨折严重程度,软组织损伤程度,其他主要脏器损伤情况等因素。肢体损伤严重性可用“创伤肢体估计评分（TEAS）”来估计.可用TEAS来决定那些肢体需要一期截肢。

Objective: To observe the treatment results of vascular injuries of the extremities. Methods: The results of treatment of 78 cases of vascular injuries associated with trauma of the extremities encountered over a period of 10 years was reported. 29 cases were injured during traffic accidents, 19 cases had industrial injuries. 20 cases had injured of the popliteal artery. Results: 31 cases had reconstruction of the injured arteries within 6 hours after trauma. Intramedullary nails were used for the fixation of the fractures in 26 cases. 53 cases had salvage of the limbs with good function. 10 cases had primary amputation and 1 needed a secondary amputation. Conclusion: The prognosis of the salvaged limb depends upon the length of ischemic periods, the severity of the neurological involvement, the severity of the fracture, the degree of soft tissue damage and the presence of the associated major injuries. The severity of limb trauma was evaluated by traumatic extremity assessment score (TEAS). All the primary amputations were determined with TEAS.